Abstract

Objective To survey vitamin K deficiency bleeding (VKDB) and document vitamin K (VK) prophylaxis practice, and compare with findings
predating withdrawal of Konakion Neonatal and guidance from the National Institute of Health and Clinical Excellence (NICE),
both occurring in 2006.

Results Eleven cases of VKDB were found: six (55%) babies received no VK prophylaxis, in five (45.5%) because parents withheld consent;
three (27.5%) babies with late VKDB received intramuscular (IM) Konakion MM (two had biliary atresia, and one was delivered
preterm); two (18%) babies received incomplete oral prophylaxis. Nine babies (82%) were breast fed. Three (27%) babies had
liver disease; four (36%), including all those with liver disease, were jaundiced at presentation after 21 days. Four (36%)
babies had intracranial haemorrhage, two probably suffering long-term morbidity. VK prophylaxis practice was defined in 236
(100%) units. All units recommended prophylaxis for every newborn: 169 (72%) IM, 19 (8%) oral, and 48 (20%) offered parental
choice. All units that recommended IM prophylaxis used Konakion MM. Oral prophylaxis always involved multidose regimens for
breastfed babies; 61 (91%) units used Konakion MM, and six (9%) used unlicensed products suitable for administration by parents.